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Fırat Üniversitesi Sağlık Bilimleri Tıp Dergisi
2020, Cilt 34, Sayı 1, Sayfa(lar) 041-047
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Typology of Yeasts and Dermatophytes Identified as the Causes of Superficial Fungal Infection in Patients with Diabetes and Determination of Antifungal Susceptibility of Yeasts
Fatime YILDIZ1, Zülal AŞÇI TORAMAN2
1Sağlık Bilimleri Üniversitesi, Gülhane Eğitim ve Araştırma Hastanesi, Tıbbi Mikrobiyoloji Kliniği, Ankara, TÜRKİYE
2Fırat Üniversitesi, Tıp Fakültesi, Tıbbi Mikrobiyoloji Anabilim Dalı, Elazığ, TÜRKİYE
Keywords: Diabetes mellitus, Trichophyton rubrum, Candida spp., antifungal resistance

Objective: Superficial skin infections due to dermatophyte and candida strains are very common in patients diagnosed with diabetes mellitus (DM). In this study, diabetic patients’ skin and nail scraping samples sent with pre-diagnosis of superficial fungal infection to mycology laboratory were analysed.

Materials and Methods: Direct microscopic examination, culture tests and conventional diagnostic methods were used in identifying fungal agents. API ID32C (VITEK, bioMérieux, France) kit was used in order to identify the yeasts. Antifungal susceptibility tests for the strains of Candida spp. were evaluated with disk diffusion method in accordance with CLSI criteria.

Results: Mean age of 80 patients included in the study was 57.73±10 (range=36-80) and 35 (44%) of them were male. Out of 130 skin and nail scraping samples, 89 were positive in direct microscopic examination. Out of 89 samples who were positive in direct microscopy, 54 samples were positive in culture test. While dermatophyte strains were the single agent in 36 samples (28%) and Candida spp. in 29 samples (22%), they were isolated together in 13 samples (10%). Candida spp. was the most common agent in samples of female patients at a rate of 27% (18/68) and Trichopyton rubrum (T.rubrum) in samples of male patients at a rate of 25.9% (16/62) (P=0.76). T.rubrum and Candida spp were the most common agents (P=0.49). Candida albicans (C.albicans) were the most common among Candida strains. Resistance to fluconazole in C.albicans, C. sake, C.parapsilosis and C. krusei was at the rates of 31%, 72%, 100% and 100% respectively and resistance to voriconazole was detected at the rates of 13%, 14%, 25% and 0% respectively (P=0.21, P=0.63 respectively).

Conclusion: The most common fungal pathogens detected in patients with DM were Candida spp and T.rubrum. Since the rates of resistance to fluconazole and voriconazole were high in Candida strains, it is considered that performing antifungal susceptibility tests in patients not responding to the treatment is very important.


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